Systematic review and validity assessment of methods used in discrete choice experiments of primary healthcare professio
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REVIEW
Open Access
Systematic review and validity assessment of methods used in discrete choice experiments of primary healthcare professionals Gregory Merlo1,2* , Mieke van Driel1 and Lisa Hall1,2
Abstract Introduction: Discrete choice experiments (DCEs) have been used to measure patient and healthcare professionals preferences in a range of settings internationally. Using DCEs in primary care is valuable for determining how to improve rational shared decision making. The purpose of this systematic review is to assess the validity of the methods used for DCEs assessing the decision making of healthcare professionals in primary care. Main body: A systematic search was conducted to identify articles with original data from a discrete choice experiment where the population was primary healthcare professionals. All publication dates from database inception to 29th February 2020 were included. A data extraction and validity assessment template based on guidelines was used. After screening, 34 studies met the eligibility criteria and were included in the systematic review. The sample sizes of the DCEs ranged from 10 to 3727. The published DCEs often provided insufficient detail about the process of determining the attributes and levels. The majority of the studies did not involve primary care healthcare professionals outside of the research team in attribute identification and selection. Less than 80% of the DCEs were piloted and few papers investigated internal or external validity. Conclusions: For findings to translate into improvements in rational shared decision making in primary care DCEs need to be internally and externally valid and the findings need to be able to be communicated to stakeholders in a way that is understandable and relevant. Keywords: Discrete choice experiment, Systematic review, Primary care, General practice, Family practice
Introduction Discrete choice experiments (DCEs) have been widely used in economics and marketing to assess how much people value the attributes of a good or service [1]. It is a method based on Lancaster’s theory, which is that a good or a service can be described by its attributes and * Correspondence: [email protected] 1 Primary Care Clinical Unit, Faculty of Medicine, University of Queensland, Level 8 Health Sciences Building, Building 16/910, Royal Brisbane & Women’s Hospital, Brisbane, QLD 4029, Australia 2 School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, Australia
that a person’s preferences for a good or service depends on their preferences for the attributes of that good or service. For example, a person’s preference for a house will depend on the attributes of that house—e.g. location, number of rooms, or the condition of the interior. A discrete choice experiment is conducted to measure the preferences for these attributes, particularly when it is not possible to measure through revealed behaviour. A DCE consists of choice tasks, where a respondent is asked, as a hypothetical scenario, to choose between two or more discrete a
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